Objective As part of the basic for cost-benefit assessment in decision for environmental protection measures, health benefit from improvement of air pollution was provided through this study. Methods According to the results from many well-done studies of local, domestic, and international authoritative institutions on relationship of air pollution and health impact, E-R functions (Exposure-Response) in terms of total mortality and morbidity of respiratory diseases from acute and chronic effects associated with increase of unit air pollutants (each 100 ?g/m3 TSP and 10 ?g/m3 SO2) were identified. As a real practice, the excess (avoidable) number of deaths and patients of respiratory diseases associated with 100 ?g/m3 TSP and 10 ?g/m3 SO2 of air pollution were estimated for Fushun City in year of 2000. The costs of medical treatment, as well as the payment for labor days were investigated. The direct and indirect economic losses from corresponding diseases were calculated. As for the estimation of economic loss from excess deaths, three methods of evaluation were applied, i.e. labor capital method; value of statistics life (VOSL), namely the method of willing to pay (WTP); and value of life year (VOLY). Results The total economic benefit combined from above aspects resulting from decreasing 100 ?g/m3 TSP ranges over 1.4 hundred millions-3.4 hundred millions yuan, accounting for 0.75%-1.95% of total product value (GDP) of Fushun City in year of 2000. Methods and indices of monetary estimation for health impact of air pollution adapted to Liaoning city was suggested. As the author's point of view, the third method of VOLY was preferable, by which, 1.48 hundred millions yuan benefit was estimated, accounting for 0.85% of GDP. Conclusions Domestic E-R functions should be worked out for assessing economic loss due to environmental pullution.

Objective To establish a mini-pool nucleic acid testing (NAT) assay using multiplex RT-nested PCR for the detection of HIV RNA, and apply it in screening for acute HIV infection among MSM. Methods Frozen EDTA plasma samples collected between Oct. 2008 and Mar. 2009 from 3 HIV infectors during window-period, a total of 30 HIV chronically infected individuals and 97 healthy subjects were used to develop the NAT assay. Plasma samples from 10 cases were pooled into one tube and centrifuged at high speed for the collection of viruses. HIV RNA was extracted. Two pairs of primers were designed according to two conserved regions of HIV RNA ( HXB2 nt 5783-nt 6228 and nt 1235-nt 2012).Multiplex RT-PCR and nested PCR were performed. Individual NAT-reactive samples were confirmed by commercially available NAT assays. The sensitivity and performance efficacy were also evaluated. The assay was then applied to 1 005 plasma specimens from MSM with negative or uncertain HIV antibody test results.These were collected in the same period as the other samples. Results ( 1 ) Two fragments of HIV were amplified successfully with the low detection limit of 162 copies/ml plasma; (2) Results of the mini-pool HIV NAT validation with samples from 3 HIV infectors during window-period were consistent with the expected values; (3) All 30 plasma samples from MSM with positive HIV antibody, which were tested by multiplex RT nested PCR, were found to be HIV RNA positive; (4) One out of 1 005 plasma samples was found to be HIV RNA positive, for this case acute infection was followed-up and sero-conversion was found. Conclusion Mini-pool NAT has good sensitivity, and may be applied to screening HIV RNA among MSM during window-period.

Objective:To explore the correlations of α-melanocyte stimulating hormone ( α-MSH) levels in serum and synovial fluid with progression of primary knee osteoarthritis (KOA). Methods:A retrospective analysis was conducted of the 96 patients who had been diagnosed as primary KOA at Department of Orthopedics, The First Hospital of Huizhou from October 2018 to October 2019. Radiographic severity of KOA was determined by Kellgren-Lawrence (K-L) grades; α-MSH levels were measured by enzyme-linked immunosorbent assay (ELISA). Levels of pro-inflammatory cytokine interleukin-1 β (IL-1 β) and matrix metalloproteinase-3 (MMP-3) were also detected. Another 64 patients with patellar dislocation, matched in age and gender, were enrolled as controls. The Numeric Pain Scale (NPS) and revised Oxford Knee Score (OKS) were employed to evaluate their symptomatic severity. Receiver operating characteristics (ROC) curve was used to compare α-MSH, IL-1 β and MMP-3 with regard to their diagnostic values in the K-L grading. Results:There were no statistically significant difference in age, gender and body mass index between the 2 groups, showing they were comparable ( P> 0.05). The α-MSH levels in synovial fluid were significantly lower in the KOA patients than in the controls [(16.9±3.8) pg/mL versus (18.8±2.7) pg/mL] ( P<0.001); there were no significant differences between the KOA patients and the controls in the serum α-MSH levels [(24.9±1.8) pg/mL versus (24.8±1.7) pg/mL] ( P>0.05). The α-MSH levels in synovial fluid were negatively correlated with K-L grades ( r=-0.382, P<0.001) and negatively correlated with NPS ( r=-0.382, P<0.001) but positively correlated with OKS ( r=0.339, P<0.001). Moreover, the α-MSH levels in synovial fluid were negatively correlated with the IL-1 β levels in synovial fluid ( r=-0.483, P<0.001) and with the MMP-3 levels in synovial fluid ( r=-0.336, P< 0.001). Conclusions:The level of serum α-MSH may not be correlated with the progression of KOA but the synovial fluid α-MSH is negatively correlated with the progression of KOA. Therefore, the expression level of α-MSH in joint synovial fluid can be used as a potential biomarker for assessment of severity of knee osteoarthritis.

ObjectiveTo investigate the immunity and seroprevalence of hepatitis A and to identify the risk factors of hepatitis A infection in 0-18 year-old children and adolescents in Shanghai.MethodsSubjects were enrolled by stratifying and clustering random sampling method.Questionnaire interview was applied to investigate the socio-demographic and behavioral factors related to hepatitis A virus (HAV),and information on HAV immunization was abstracted from the immunization registration book of each subject.The enzyme-linked immunosorbent assay (ELISA) was used to qualitatively detect HAV IgM and quantitatively measure total HAV antibody in all subjects.Risk factors associated with HAV among the subjects without HAV vaccination were analyzed.ResultsA total of 2431 subjects were enrolled in the present study with negative HAV IgM antibody and total HAV antibody in 1483 subjects were sero-positive with positivity rate of 61％.Total HAV antibody positivity rates were declined with age increasing and were significantly higher in subjects with HAV vaccination than those without HAV vaccination records.Salad food,eating together without food separation in school and endoscopy inspection were risk factors for HAV infection.ConclusionsHAV vaccination strategies remarkably improve the total HAV antibody seropositive rate in children and adolescents in Shanghai.The risk of HAV infection exists if HAV vaccination is not administrated comprehensively.Therefore,strengthening HAV vaccination and health education are important for children and adolescents to prevent and control of hepatitis A in Shanghai.

Objective:To explore the efficacy and safety of hyaluronic acid filler VYC-20L for full-face lifting in aesthetic seeking patients.Methods:Between November 2020 and November 2021, a total of 216 aesthetic seeking patients were enrolled in Shanghai Chingho Outpatient Department, World Path Clinic International, Qihe Medical Beauty Hospital and Qinhuangdao Qiaozhi Beauty Hospital, including 37 males and 179 females, aged 25-67 (41.42±10.93) years. According to the needs and requirements, the novel injection technique of " ROYGBbP-rainbow lifting method" was used to inject hyaluronic acid filler VYC-20L. The global aesthetic improvement scale (GAIS) and the treatment satisfaction questionnaires were scored and evaluated before the injection, and at follow-up visits 1, 6, and 12 months after the injection. Any adverse reaction or adverse events presenting or reported by the patients post-injection were recorded.Results:At 1 month, 6 months and 12 months after the injection, about 203 (94.0%), 208 (96.3%) and 205 (94.9%) of the aesthetic seeking patients rated their full-face appearance as " excellently improved" or " much improved" on the GAIS, respectively. And 12 months after the injection, the overall facial satisfaction scores and appearance recognition scores of all aesthetic seeking patients were all significantly higher than those before injection ( P<0.01). 197 (91.2%), 198 (91.7%) and 198 (91.7%) of the aesthetic seeking patients were " very satisfied" or " relatively satisfied" with the treatment at 1 month, 6 months and 12 months, respectively. Treatment site responses most frequently reported were tenderness, bruising, topical swelling and skin redness. Most of the symptoms were moderate or mild feeling, lasting for no more than two weeks. Conclusions:The application of hyaluronic acid filler VYC-20L is safe and effective for full-face lifting in aesthetic seeking patients, which can significantly improve facial sagging and rejuvenate the face. The effect of improvements can last for 12 months.

Cryptococcal meningitis is a common and refractory central nervous system infection,with high rates of mortality and disability.The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion.Based on the current situation of cryptococcal meningitis in China,the management of cryptococcal meningitis includes 6 aspects:introduction,microorganism identification,clinical manifestations and diagnosis,principles of antifungal therapy,treatment of refractory and recurrent meningitis,treatment of intracranial hypertension.There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis.This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines.The importance of early diagnosis,combined long-term antifungal therapy,control of intracranial hypertension are emphasized.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

OBJECTIVE: To investigate the effects of on the acoustic characteristics of tumor tissue and how such acoustic changes affect the efficacy of high-intensity focused ultrasound (HIFU) ablation in nude mice. METHODS: Forty mice bearing human breast cancer cell (MDA-MB-231) xenograft were randomized into experimental group (=20) and control group (=20) for intravenous injection of suspension (200 μL, 4 × 10 cfu/mL) and PBS (200 μL) for 3 consecutive days, respectively. Before and at 3 and 7 days after the first injection, shear wave elastography was used to evaluate the hardness of the tumor tissue. On day 7 after the first injection, 10 mice from each group were sacrificed and the sound velocity and sound attenuation of the tumor tissues were measured. The changes in the collagen fibers in the tumors were evaluated using Masson staining, and neovascularization in the tumor was assessed with immunohistochemistry for platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31). The remaining 10 tumor-bearing mice in each group were subjected to HIFU ablation, and the ablation efficiency was evaluated by assessing the changes in irradiation gray values, coagulative necrosis volume, energy efficiency factor (EEF) and irradiation area and by pathological examination with HE staining. RESULTS: In the experimental group, the collagen fibers in the tumor tissues were strong and densely aligned, and the tumors contained fewer new blood vessels showing strip-or spot-like morphologies. In the control group, the collagen fibers in the tumors were thin and loosely arranged, and the tumors showed abundant elongated or round new blood vessels. colonized in the tumor 7 days after the injection, and the tumor hardness was significantly greater in the experimental group than in the control group (=0.01); the acoustic velocity (=0.001) and the acoustic attenuation (=0.000) of the tumor tissues were also greater in the experimental group. HIFU irradiation resulted in significantly greater changes in the gray scale of tumor (=0.0006) and larger coagulative necrosis volume (=0.0045) in the experimental group than in the control group, and the EEF was significantly smaller in the experimental group (=0.0134). CONCLUSIONS can cause changes in collagen fiber content, acoustic velocity and attenuation in the tumor tissue and reduce the EEF of HIFU irradiation, thereby improving the efficacy of HIFU irradiation.
Acoustics ; Animals ; Bifidobacterium ; pathogenicity ; Breast Neoplasms ; pathology ; Collagen ; Elasticity Imaging Techniques ; High-Intensity Focused Ultrasound Ablation ; Humans ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Random Allocation